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06-0620 (AR)P.O. BOX 1504 k 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Application Number: Property Address: APN:' Application description: Property Zoning: Application valuation: Applicant: 06-00000620 51075 CALLE"PALOMA 770-142-0.11-100 -OOOOOC ADDITION - RESIDENTIAL LOW DENSITY RESIDENTIAL 38707 Architect or BUILDING & SAFETY DEPARTMENT BUILDING PERMIT VOICE (760) 777-7012 FAX (760) 777-7011 INSPECTIONS (760) 777-7153 Owner: BARAJAS ALBERTO 51-075,CALLE'PALOMA LA QUINTA, CA 92253 Other'struct info C Contractor: Owner Date: /26/06 ' LIOENSED'CONTRACTOR'S DECLARATION. WORKER'S COMPENSATION DECLARATION Ihereby affirm under.penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with I hereby affirm under penalty of perjury one of the following•'declaratiom - Section 7000) of'Division 3 of the Business and Professionals Code, and my License is in full force and effect. _ I have and will maintain a'certifidate of consent to self, insure for workers' -compensation, as provided License Class: - - License No.: for by Section 3700 of the Labor'Code, for the performance of the work.for which this permit is - issued. Date: . Contractor: _ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code,. for, the performance of -the work'for which this permit is issued. My workers' compensation t OWNER -BUILDER DECLARATION insurance carrier and policy number are: ' I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the Carrier - 1 . 00 Policy:Number - NO e following reason.lSec. 7031 .5, Business and Professions Code: Any city or county that requires.a permit to I certify that, in the performance•of'the work for which this permit is issued, I shall not employ any construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for tfie person in any',manner so as to'become. subject to the workers' compensation laws ofCalifornia, r permit to file'a signed statement that he�or she is licensed pursuant to the provisions of theZo.ntractor's State and agree;that,'if l should ome subject to the workers' compensation provisions of Section -a Licensel'aw (Chapter 9lcpmmencjng with Section 7000) of Division Sof tfie Business_and Professions Code) or.. 3700, the Labor Code, I all fotthw�th cor9fy,wiih those proyisionsi .that he she is exempt therefrom and the basis.forihe alleged exemption Any violation of Section 7031 .5,by Iq e any applicant for a permitsublects.the: applicant to a civil penalty of not more than five hundred dollars IS500L: e `�` I. icanti ✓) I, as owner of the=property, or my employees with wages as their sole compensation, will:do.the work; and, -VV the stiucture'is not intended or offered for sale ISec. 7044, Business and Professions Code: The' . WARNING:' FAILURE TO SECURE WORKERS' COMPENSATION OVERAGE IS UNLAWFUL, AND SHALL contractors` State License Law does not apply :to an owner of property who builds or improves thereon, SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES -AND CIVICFINES'UP'TO'ONE HUNDRED THOUSAND and wtio does the work himself or herself through his or her own employees, provided that the.. DOLLARS (S,1100,000). IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN improvements are not intended or offered for sale. If, however, the building or improvement is sold 'within SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.. one year of completion, the owner -builder will have the burden of proving thaf-he-or she did not build or . improve for the purpose of sale.): - APPLICANT ACKNOWLEDGEMENT - (_ 1 I, as owner of -the property; am exclusively contracting with licensed contractors to construct the project-ISec. AMPORTANT Application is- hereby, made -to -the Director. of. Building and Safety for, ;aipermitsubject-t_o-the, 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of conditions and restrictions set forth on this -application. : property who builds or improves thereon, and who -contracts for the projects with a contractor's) licensed 1. Each person upon whose behalf this application is made, each person at whose request and for. pursuant to the Contractors' State License Law.). whose benefit work is performed under or.pursuantto any permit issued as a result of this application, 1 _ 1 I am exempt under Sec. B.&P for this reason the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents and employees for any act or omission related to the work being �� performed under or following issuance of this permit. - ate: G caner. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject CONSTRUCTION LENDING GENCY permit to cancellation. I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the I certify that I have read this application and state that the above information is correct. I agree to comply with all work for which this permit is issued (Sec. 3097, Civ. C.). city and county ordinances and state laws relating to buildi g construction, and her y authorize representatives of this county to enter upon the ve-mentioned property o inspection purposes Lender's Name: Si ure IApplicant or Agent): , Lender's Address: LQPERMIT LQPERAIIT Application Number . . . . . 06-00000620 Permit . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 343.00 P1an,Check Fee 222.95 Issue Date . . . . Valuation . . . . 38707 Expiration Date 10/23/06 Qty Unit Charge Per Extension BASE FEE 252.00 14.00 --------------- 6.5000 ----------- THOU BLDG ----------- 25,001-50,000 --------------------------- 91.00 ------------ Permit ELECT -.ADD/ALT/REM Additional desc . . Permit Fee 37.51 Plan Check Fee 9.38 Issue Date Valuation . . 0 Expiration Date 10/23/06 Qty Unit Charge Per Extension BASE FEE 15.00 634.00 .0350 ELEC NEW RES - 1 OR 2 FAMILY 22.19 16.00 ----------------------=----------------------------------------------------- .0200 ELEC GARAGE OR NON-RESIDENTIAL .32 Permit . . . MECHANICAL Additional desc . -Permit Fee 46.06 Plan Check Fee •11.50 Issue Date Valuation 0 Expiration Date 10/23/06 Qty Unit Charge Per Extension BASE FEE 15.00 1.00 9.0000 EA MECH FURNACE <=100K 9.00 1.00 9.0000 EA . MECH B/C <=3HP/100K BTU 9.00 2.00 ---------------------------------------------------------------------------- 6.5000 EA MECH VENT FAN 13.00 Permit. . . . . PLUMBING Additional desc . Permit Fee . . . . 69.00 Plan Check Fee 17.25 Issue Date Valuation .. . . . 0 Expiration Date 10/23/06 Qty ' Unit Charge Per Extension BASE FEE 15.00 8.00 6.0000 EA PLB FIXTURE 48.00 1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00 1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS 3.00 Application Number . . . . . 06-00000620 ---------------------------------------------------------------------------- Special Notes and Comments 634 sq. ft. addition and 160 sq. ft. patio. ---------------------------------------------------------------------------- Other Fees . . . . . . . . ENERGY REVIEW FEE 22.30 STRONG MOTION .(SMI.) - RES 3.87 Fee summary ----------------- Charged ---------- Paid -------------------- Credited ---------- Due Permit Fee Total 495.51 .00 .00 495.51, Plan Check Total 261.08 .00 .'00 261.08 Other Fee Total 26.17 .00 .00 26.17 Grand Total 782.76 .00 .00 782.76 LQPERAIIT m gin City of La Quinta Building;u Safety Division P.O. Box T504; 78-495 Calle Tampico La Quinta, CA 92253 - (760) 7.77-7012 Building Permit Application and Tracking.Sheet Permit # 06 - 62.E Project Address: �j — b� 5 �� y Owner's Name: e (�� Q A. P. Number: 7-7 Z� dl1 Address: 1j, t p Legal Description:.-` ST, Zip: Contractor: n _ f✓Wt'� v � �'i - Telephone: -Address: Project Description: City, ST, Zip: Q,S. S r ✓L Telephone: City. Lic. #: ' ra State Lic. # : Arch., Engr., Designer: ?� e� C •� Address: '% 0 _ �h• `lt� "�S o !) City, ST, Zip: �. Gl Vl- Ge- d�Z3 Telephon �e s i�-� pn . s, State Lic. #: 2 3 S 7j Name of Contact Person:. �: �� ;� ' Construction Type:VQ Occupancy: L Project type (circle one): New_: dd'n Alter . Repair. Demo Sq Ft.: 3 # Stories: , .I # Units: Telephone # of Contact Person: ti X04" .Estimated Value of Project.. �. 0, . 6_= APPLICANT: DO NOT.WRITE:BELOW THIS LINE.. . # Submittal.. Req'd Recd TRACKING . PERMTT FEES Z Plan Sets ' ' 'Plan Check submitted Item Amount Structural Calcs. Reviewed, ready f corrections Plan'Check Deposit Truss Calcs. Called Contact P L S„pG 3c3� x Plan°Check Balance Energy Calcs. Plans picked up r• ` , Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2 Review, ready for correctio /is ue Electrical Subcontactor List Called Contact Person r'(p . Plumbing Grant Deed Plans picked up S.M.I. H.O.A. Approval Plans resubmitted GradingY IN HOUSE:- Review, ready for corrections/issue Developer impact Fee Planning Approval Called Contact Person A.I.P.P. Pub. Wks. Appr Date of permit issue . School Fees y,Tofal;Permit Fees ipliw P/u 44S. Date 4/26/06 No. 28412 Owner Alberto Barajas Address 51075 Calle Paloma City La Quinta Zip Tract # Type Residential Addition CERTIFICATE OF COMPLIANCE Desert Sands Unified School District 47950 Dune Palms Road La Quinta, CA 92253 (760) 771-8515 APN # Jurisdiction Permit # Study Area No. of Units ao Z4 o BERMUDA DUNES r Cr RANCHO MIRAGE INDIAN WELLS PALM DESERT y LA QUINTA ,Zy %INDIO yr�` 770-142-011 La Quinta 1 Lot # No. Street S.F. Lot # No. Street S.F. Unit 1 51075 Calle Paloma 634 Unit 6 Unit 2 Unit 7 Unit 3 Unit 8 Unit 4 Unit 9 Unit 5 Unit 10 Comments At the present time, the Desert Sands Unified School District does not collect fees on garagestcarports, covered patios/Walkways, residential additions under 5 00 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile ho mes. It has been determined that the above-named owner is exempt from paying school fees at this time due to the following reason: EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to Education Code Section 17620 and Government Code 65995 Et Seq. in the amount of $2.63 X 634 S.F. or $1,667.42 have been paid for the property listed above and that building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued. Fees Paid By Cash - Susan Barajas' Check No. Name on the check Telephone 564.3162 Funding Residential By Dr. Doris Wilson Superintendent Fee collected Payment Recd $1,667.42 "' Over/Uhiler �. Signature �e NOTICE: Pursuant to Government Code Section 66020(d)(1), is will a to notify you that the 90 -day approval period In which;you,may protest the fees o r other payment identified above will begin to run from the date on the building or installation permit for this project is issued, or from the date on which those amounts are paid to the District(s) or to another public entity authorized to collect them on the District(s) behalf, whichever is earlier. NOTICE: This Document NOT VALID if Duplicated Embossed Original -Building Department/Applicant Copy -Applicant/Receipt Copy -Accounting I Page 3 of 3 I 'it ;-w- "zj,� ssq op, Please note ;New Email -,Address: shar6n.mcgilvrgy@dsusd.us I U (11v6L "At -,r, jj injoUoccq .%j g. Inu iLow Ax .4, try Ou #147%4 M cc -uv", va% bL6ce, La z--noptj, c11 ,+t: j: "I =j cj$4 QV 1-:� hmzt •uj ;a (;Oq;. e;�Sc-fqja I I' M L',OiJX k -,fl f PSI 1,;; dUw4-?\!;btV-,A!�j C p.." -Ps-Lbu 'N-im oo\ MJ --Q4VqGVt 1.) 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